The use of the FACT-H&N (v4) in clinical settings within a developing country: A mixed method study

Functional assessment of cancer therapy - head & neck (FACT-HN) translation and validation in Serbian

This study aimed to translate and validate the Functional Assessment of Cancer Therapy - Head & Neck (FACT-HN) in a Serbian-speaking population, assessing its psychometric properties and utility in evaluating the quality of life in head and neck cancer patients. The research focuses on determining the translated questionnaire's reliability, validity, and cultural relevance. A total of 106 Serbian-speaking head and neck cancer patients completed the translated FACT-HN, along with other validated instruments, including the EORTC QLQ-C30, EORTC QLQ-HN43, CES-D, and GAD-7. The translation followed a standard internationally accepted procedure. Psychometric analyses were conducted using confirmatory and exploratory factor analysis, Pearson correlations, and reliability measures such as Cronbach's alpha and intraclass correlation coefficients. The Serbian version of the FACT-HN showed excellent internal consistency across all subscales, with Cronbach's alpha ranging from 0.70 to 0.89. Confirmatory factor analysis confirmed the five-factor structure. Strong correlations were observed between the FACT-HN and other validated QoL measures, particularly with the EORTC QLQ-C30 and EORTC QLQ-HN43. Convergent validity was satisfactory for all components except the Social Well-Being component. The Serbian version of the FACT-HN is a valid and reliable tool for assessing the quality of life in head and neck cancer patients. It provides a comprehensive assessment of physical, social, emotional, and functional well-being, making it valuable for clinical and research applications in Serbian-speaking populations. Further research is needed to assess its sensitivity to longitudinal treatment-related changes.

Translation, linguistic validation and reliability of FACT-H&N questionnaire in Oral Cancer patients in Sudan

BACKGROUND

This study aimed to translate and validate an Arabic version of the Functional Assessment of Cancer Therapy Head and Neck Scale (FACT-H&N, v-4) for use among Sudanese oral cancer patients.

METHODS

The instrument underwent translation and validation following the standard FACT translation methodology. The translated instrument was pre-tested for face validity and content validity using semi-structured, in-depth interviews with ten oral cancer patients to assess acceptability. The questionnaire was pilot tested with 60 patients; reliability was tested for internal consistency with Cronbach's alpha while construct validity was tested using 'known-group validity'.

RESULTS

The pre-test study revealed no major issues, apart from a reluctance to answer questions on sexual satisfaction. The FACT-H&N demonstrated good internal consistency, it considered five particular constructs: PWB, SWB, EWB, FWB and FACT-H&N, their Cronbach's α values were positive and close to 1 with values of 0.85, 0.788, 0.86, 0.895 and 0.703 respectively, indicating that the questionnaire was valid and the responses consistent. Sixty patients were asked the global health-related quality of life item, 36.3% rated their QOL as very good or good (36.3%), while 41.7% rated it as average, and 21.7% as poor or very poor. Then FACT subscale mean scores were tabulated against three categories; patients with very poor/poor recorded significantly lower scores indicating construct validity. Some psychometric properties were consistent with other FACT-H&N translations such as the Chinese, French, Pakistani and Malaysian.

CONCLUSIONS

This study validates the Arabic version of the FACT-H&N. It is a reliable tool and, will assist further QoL research in other Arabic-speaking countries.

Effects of stigma, hope and social support on quality of life among Chinese patients diagnosed with oral cancer: a cross-sectional study

BACKGROUND

Improving quality of life (QoL) has been one of the goals of health care for people living with oral cancer. This study aimed to assess QoL and investigate the effects of stigma, hope, and social support on QoL among Chinese oral cancer patients.

METHODS

A cross-sectional study was conducted at the Department of Stomatology, Shengjing Hospital of China Medical University and Stomatology Hospital of China Medical University in Liaoning Province, China, between May 2016 and October 2017. A total of 230 oral cancer patients were recruited to complete a questionnaire including the Functional Assessment of Cancer Therapy-Head and Neck (FACT-H&N), the Social Impact Scale (SIS), the Herth Hope Index (HHI) and the Multidimensional Scale of Perceived Social Support (MSPSS). Univariate one-way ANOVA/t-test, Person's r and hierarchical linear regression analysis were conducted to explore the factors influencing QoL and the relationships between stigma, hope, perceived social support and QoL.

RESULTS

The mean QoL score was 90.85 ± 20.15 among the patients with oral cancer. Stigma was negatively related to QoL, explaining 39.3% of the variance. In addition, hope and perceived social support were positively associated with QoL, explaining 8.1% of the variance.

CONCLUSION

Overall, Chinese patients with oral cancer suffer from low QoL. Stigma was significantly and negatively associated with QoL, while hope and perceived social support were positively associated with QoL. Oral cancer patients' psychological states should be addressed, and adequate intervention based on positive psychological resources should be provided to improve the QoL of patients with oral cancer.

Quality of life associated factors in head and neck cancer patients in a developing country using the FACT-H&N

Health-related quality of life (HRQoL) associated factors are vital considerations prior to treatment decision-making for head and neck cancer patients. The study aimed to identify potential socio-demographic and clinical prognostic value of HRQoL in head and neck cancer patients in a developing country. The Functional Assessment of Cancer Therapy-Head and Neck (FACT-H&N)-V4 in Urdu language was administered among 361 head and neck cancer patients. Data were statistically tested through multivariate analysis of variance (MANOVA) and regression modeling to identify the potentially associated factors. Treatment status, tumor stage and tumor site had the strongest negative impact on patients HRQoL, with a statistically significant decrement in FACT summary scales (effect size >0.15). Moderate associated factors of HRQoL included treatment type, marital status, employment status and age (effect size range 0.06-0.15). Weak associated factors of HRQoL with a small effect size (>0.01-0.06) included tumor size and type, gender, education level and ethnicity. This study reports 12 socio-demographic and clinical variables that have a significant impact on HRQoL of head, and neck cancer patients, and that should be considered during treatment decision-making by multidisciplinary teams and also in future HRQoL studies conducted in other developing countries.